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TumorDiagnostik & Therapie 2010; 31(1): 29-38
DOI: 10.1055/s-0029-1245196
Thieme Onkologie Aktuell

© Georg Thieme Verlag KG Stuttgart · New York

Tumormarker für Schilddrüsenkarzinome

Tumor Marker for Thyroid CarcinomaR. Görges1 , V. Hartung1 , B. L. Herrmann2 , A. Bockisch1 , L. S. Freudenberg1
  • 1Klinik für Nuklearmedizin, Universitätsklinikum Essen
  • 2Klinik für Endokrinologie, Universitätsklinikum Essen
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Publication History

Publication Date:
04 March 2010 (online)

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Zusammenfassung

Thyreoglobulin (hTg) bzw. Kalzitonin (hCt) sind etablierte humorale Tumormarker für die Therapieüberwachung und Nachsorge der behandelten thyreoidalen Follikelzell- bzw. C-Zell-Karzinome. Hierfür besitzen diese Analyten eine im Vergleich zu vielen anderen Tumormarkern hohe diagnostische Spezifität, die mit dem Ausmaß der Radikalität der Schilddrüsenablation zunimmt. In den letzten Jahren werden Assays mit zunehmender funktioneller Sensitivität angeboten, die allerdings mit neuen Herausforderungen an die labortechnische Durchführung, die Qualitätssicherung sowie die Interpretation der im „ultrasensitiven” Bereich messbaren Werte einhergehen. Ohnehin sind hTg und hCt als relativ anspruchsvolle Laborparameter anzusehen. Die Messergebnisse sind zum Teil deutlich abhängig von diversen In-vivo- und In-vitro-Einflussfaktoren, aber auch bei konstanten Rahmenbedingungen ist die Vergleichbarkeit der gemessenen Werte zwischen verschiedenen Assays nicht ohne weiteres garantiert. Hinsichtlich der hCt-Bestimmung bieten Assays mit weitgehend selektiver Erfassung der monomeren (reifen) Kalzitoninform den Vorteil einer weiteren Steigerung der diagnostischen Spezifität. Abgesehen von der Überwachung der wegen eines Schilddrüsenkarzinom behandelten Patienten wird die hCt-Bestimmung von zahlreichen Fachgesellschaften auch bei der Dignitätsabklärung thyreoidaler Raumforderungen als gerechtfertigt angesehen, wohingegen die hTg-Bestimmung nicht als Routinemaßnahme zur Schilddrüsenknotenabklärung in die Leitlinien aufgenommen wurde. Die hTg-Bestimmung kann aber bei der Evaluierung bestimmter benigner Schilddrüsenprozesse indiziert sein wie der Differenzialdiagnose der konnatalen Hypothyreose, der Abklärung einer vermuteten faktitiellen Hyperthyreose oder als Aktivitätsmarker für destruierende Schilddrüsenprozesse wie der subakuten oder Amiodaron-induzierten Thyreoiditis.

Abstract

Thyroglobulin and calcitonin are established humoral tumor markers for therapy monitoring and follow up of thyroid cancer of follicular origin or medullary thyroid cancer, respectively. In comparison to many other tumor markers these analytes offer a high diagnostic specificity, which increases with the radicalness of thyroid ablation. Over the last years, assays with rising functional sensitivity became commercially available, being however a challenge in respect to laboratory performance, quality assurance and medical judgement in the „ultrasensitive” range of detectable concentrations. Anyway, hTg and hCT must be considered to be ambitious laboratory parameters. The results considerably depend on various in vivo and in vitro influences, and even under constant conditions, different assays may not necessarily produce identical results. hCt assays that measure the monomer (mature) calcitonin form have the advantage of an enhancement of the diagnostic specificity. Apart from follow up investigations in treated MTC patients, a couple of medical societies assume hCt measurement to be justified in the presence of a thyroid nodule. In contrast, guidelines do not recommend hTg measurement as a routine procedure for the assessment of the malignancy of thyroid nodules. However, hTg measurement may have an indication in differential diagnosis of connatal hypothyroidism, in assumed thyrotoxicosis factitia and as a marker of destructive thyroidal disease like subacute or amiodarone-induced thyroiditis.

Schlüsselwörter

Thyreoglobulin (hTg) - Kalzitonin (hCt) - differenziertes Schilddrüsenkarzinom - medulläres Schilddrüsenkarzinom - Nachsorge - Schilddrüsenknoten

Key words

thyroglobulin (hTg) - calcitonin (hCt) - differentiated thyroid cancer - medullary thyroid cancer - restaging - thyroid nodule

Literatur

  • 1 Baloch Z, Carayon P, Conte-Devolx B. et al . Guidelines Committee, National Academy of Clinical Biochemistry. Laboratory medicine practice guidelines. Laboratory support for the diagnosis and monitoring of thyroid disease.  Thyroid. 2003;  13 3-126
    CrossrefPubMedGoogle Scholar
  • 2 Bieglmayer C, Vierhapper H, Dudczak. et al . Measurement of calcitonin by immunoassay analyzers.  Clin Chem Lab Med. 2007;  45 662-666
    CrossrefPubMedGoogle Scholar
  • 3 Boi F, Maurelli I, Pinna G. et al . Calcitonin measurement in wash-out fluid from fine needle aspiration of neck masses in patients with primary and metastatic medullary thyroid carcinoma.  Clin Endocrinol Metab. 2007;  92 2115-2118
    PubMedGoogle Scholar
  • 4 Borson-Chazot F, Bardet S, Bournaud C. et al . Guidelines for the management of differentiated thyroid carcinomas of vesicular origin.  Ann Endocrinol (Paris). 2008;  69 472-486
    PubMedGoogle Scholar
  • 5 British Thyroid Association, Royal College of Physicians . Guidelines for the management of thyroid cancer . , 2nd edition. Perros P, ed. http://www.british-thyroid-association.org/news/docs/thyroid_cancer_guidelines_2007.pdf
    PubMed
  • 6 Chow E, Siddique F, Gama R. Thyrotoxicosis factitia: role of thyroglobulin.  Ann Clin Biochem. 2008;  45 447-448
    CrossrefPubMedGoogle Scholar
  • 7 Cooper DS, Doherty GM, Haugen BR. et al . American Thyroid Association Guidelines Taskforce. Management guidelines for patients with thyroid nodules and differentiated thyroid cancer.  Thyroid. 2006;  16 109-142
    CrossrefPubMedGoogle Scholar
  • 8 Costante G, Meringolo D, Durante C. et al . Predictive value of serum calcitonin levels for preoperative diagnosis of medullary thyroid carcinoma in a cohort of 5 817 consecutive patients with thyroid nodules.  J Clin Endocrinol Metab. 2007;  92 ((2)) 450-455
    CrossrefPubMedGoogle Scholar
  • 9 d’Herbomez M, Caron P, Bauters C. et al . Reference range of serum calcitonin levels in humans: Influence of calcitonin assays, sex, age, and cigarette smoking.  Eur J Endocrinol. 2007;  157 749-755
    CrossrefPubMedGoogle Scholar
  • 10 Dietlein M, Dressler J, Grünwald F. et al . Deutsche Gesellschaft für Nuklearmedizin Guideline for in vivo- and in vitro procedures for thyroid diseases (version 2).  Nuklearmedizin. 2003;  42 109-115
    PubMedGoogle Scholar
  • 11 Dietlein M, Wieler H, Schmidt M. et al . Calcitonin-Screening bei der Knotenstruma?.  Nuklearmedizin. 2008;  47 65-72
    PubMedGoogle Scholar
  • 12 Dietlein M, Dressler J, Eschner W. et al . Procedure guideline for iodine-131 whole-body scintigraphy for differentiated thyroid cancer (version 3).  Nuklearmedizin. 2007;  46 206-212
    PubMedGoogle Scholar
  • 13 Djemli A, Fillion M, Belgoudi J. et al . Clin Twenty years later: a reevaluation of the contribution of plasma thyroglobulin to the diagnosis of thyroid dysgenesis in infants with congenital hypothyroidism.  Biochem. 2004;  37 818-822
    PubMedGoogle Scholar
  • 14 Dralle H, Schwarzrock R, Lang W. et al . Comparison of histology and immunohistochemistry with thyroglobulin serum levels and radioiodine uptake in recurrences and metastases of differentiated thyroid carcinomas.  Acta Endocrinol (Copenh). 1985;  108 504-510
    PubMedGoogle Scholar
  • 15 Edmonds CJ, Willis CL. Serum thyroglobulin in the investigation of patients presenting with metastases.  Br J Radiol. 1988;  61 317-319
    CrossrefPubMedGoogle Scholar
  • 16 Elisei R, Bottici V, Luchetti F. et al . Impact of routine measurement of serum calcitonin on the diagnosis and outcome of medullary thyroid cancer: Experience in 10 864 patients with nodular thyroid disorders.  J Clin Endocrinol Metab. 2004;  89 163-168
    CrossrefPubMedGoogle Scholar
  • 17 Engelbach M, Görges R, Forst T. et al . Improved diagnostic methods in the follow-up of medullary thyroid carcinoma by highly specific calcitonin measurements.  J Clin Endocrinol Metab. 2000;  85 1890-1894
    CrossrefPubMedGoogle Scholar
  • 18 Engelbach M, Heerdt S, Görges R. et al . Is there an ectopic secretion of monomeric calcitonin in the human being?.  Langenbecks Arch Surg. 1998;  383 456-459
    CrossrefPubMedGoogle Scholar
  • 19 Eustatia-Rutten CF, Smit JW, Romijn JA. et al . Diagnostic value of serum thyroglobulin measurements in the follow-up of differentiated thyroid carcinoma, a structured meta-analysis.  Clin Endocrinol (Oxf). 2004;  61 61-74
    CrossrefPubMedGoogle Scholar
  • 20 Fatemi S, LoPresti JS. A consensus report of the role of serum thyroglobulin as a monitoring method for low-risk patients with papillary thyroid carcinoma.  J Clin Endocrinol Metab. 2003;  88 4507-4508
    CrossrefPubMedGoogle Scholar
  • 21 Francis Z, Schlumberger M. Serum thyroglobulin determination in thyroid cancer patients.  Best Pract Res Clin Endocrinol Metab. 2008;  22 1039-1046
    CrossrefPubMedGoogle Scholar
  • 22 Frasoldati A, Toschi E, Zini M. et al . Role of thyroglobulin measurement in fine-needle aspiration biopsies of cervical lymph nodes in patients with differentiated thyroid cancer.  Thyroid. 1999;  9 105-111
    CrossrefPubMedGoogle Scholar
  • 23 Gerfo PL, Colacchio T, Colacchio D. et al . Thyroglobulin in benign and malignant thyroid disease.  JAMA. 1979;  241 923-924
    CrossrefPubMedGoogle Scholar
  • 24 Gimm O, Ukkat J, Dralle H. Determinative factors of biochemical cure after primary and reoperative surgery for sporadic medullary thyroid carcinoma.  World J Surg. 1998;  22 562-567
    CrossrefPubMedGoogle Scholar
  • 25 Giovanella L, Ceriani L, Ghelfo A. et al . Thyroglobulin assay during thyroxine treatment in low-risk differentiated thyroid cancer management: Comparison with recombinant human thyrotropin-stimulated assay and imaging procedures.  Clin Chem Lab Med. 2006;  44 648-652
    CrossrefPubMedGoogle Scholar
  • 26 Giovanella L, Ceriani L, Suriano S. et al . Thyroglobulin measurement on fine-needle washout fluids: Influence of sample collection methods.  Diagn Cytopathol. 2009;  37 42-44
    CrossrefPubMedGoogle Scholar
  • 27 Giovanella L, Crippa-S, Cariani L. Serum calcitonin-negative medullary thyreoid carcinoma: role of CgA and CEA as complementary markers.  Int J Biol Markers. 2008;  23 129-131
    PubMedGoogle Scholar
  • 28 Giovanella L. Highly sensitive thyroglobulin measurements in differentiated thyroid carcinoma management.  Clin Chem Lab Med. 2008;  46 1067-1073
    CrossrefPubMedGoogle Scholar
  • 29 Girelli ME, Busnardo B, Amerio R. et al . Critical evaluation of serum thyroglobulin (Tg) levels during thyroid hormone suppression therapy versus Tg levels after hormone withdrawal and total body scan: Results in 291 patients with thyroid cancer.  Eur J Nucl Med. 1986;  11 333-335
    PubMedGoogle Scholar
  • 30 Girelli ME, Busnardo B, Amerio R. et al . Serum thyroglobulin levels in patients with well-differentiated thyroid cancer during suppression therapy: Study on 429 patients.  Eur J Nucl Med. 1985;  10 252-254
    PubMedGoogle Scholar
  • 31 Görges R, Bockisch A. Der Schilddrüsenknoten und der Stellenwert der Tumormarkerbestimmung.  Der Nuklearmediziner. 2008;  31 228-236
    Article in Thieme ConnectPubMedGoogle Scholar
  • 32 Görges R, Brandt-Mainz K, Freudenberg L. et al . Kontinuierliche Sensitivitatssteigerung in der Schilddrusenkarzinom-Nachsorge im Verlauf dreier Thyreoglobulin-IMA-Generationen.  Nuklearmedizin. 2003;  43 157-166
    PubMedGoogle Scholar
  • 33 Görges R, Jentzen W, Müller SP. et al . Untersuchungen zur Dynamik des Thyreoglobulin-Anstieges beim progredienten differenzierten Schilddrüsenkarzinom.  Nuklearmedizin. 2009;  48 A86 , (P21)
    PubMedGoogle Scholar
  • 34 Görges R, Lind T, Schostok L. et al . Serielle ultrasensitive Thyreoglobulin-Bestimmung: Differenzierung zwischen natürlichen Schwankungen bei DTC-Patienten in Remission und Tumorrezidiven.  Nuklearmedizin. 2006;  45 A29 , (V66)
    PubMedGoogle Scholar
  • 35 Görges R, Maniecki M, Jentzen W. et al . Development and clinical impact of thyroglobulin antibodies in patients with differentiated thyroid carcinoma during the first 3 years after thyroidectomy.  Eur J Endocrinol. 2005;  153 49-55
    CrossrefPubMedGoogle Scholar
  • 36 Hahm JR, Lee MS, Min YK. et al . Routine measurement of serum calcitonin is useful for early detection of medullary thyroid carcinoma in patients with nodular thyroid diseases.  Thyroid. 2001;  11 73-80
    CrossrefPubMedGoogle Scholar
  • 37 Hartung V, Broecker M, Bockisch A. et al . Assay-Abhängigkeit der Calcitonin-Zielbereiche für „biochemical-cured” MTC-Patienten in der Nachsorge.  Nuklearmedizin. 2010;  49 in print
    PubMedGoogle Scholar
  • 38 Hartung V, Lahner H, Broecker M. et al . Vergleich verschiedener Calcitonin-Assays in der Nachsorge bei Patienten mit medullärem Schilddrüsenkarzinom.  Nuklearmedizin. 2010;  49 in print
    PubMedGoogle Scholar
  • 39 Heinze H G, Rall M. The value of a new IRMA for determining thyroglobulin.  Nuklearmedizin. 1992;  31 172-177
    PubMedGoogle Scholar
  • 40 Henriksen JH, Schifter S, Moller S. et al . Increased circulating calcitonin in cirrhosis Relation to severity of disease and calcitonin gene-related peptide.  Metabolism. 2000;  49 47-52
    CrossrefPubMedGoogle Scholar
  • 41 Herrmann B L, Schmid K W, Görges R. et al . Calcitonin screening and pentagastrin testing: predictive value for the diagnosis of medullary carcinoma in nodular thyroid disease.  Eur J Endocrinol. 2010;  162 in print
    PubMedGoogle Scholar
  • 42 Hocevar M, Auersperg M, Stanovnik L. The dynamics of serum thyroglobulin elimination from the body after thyroid surgery.  Eur J Surg Oncol. 1997;  23 208-210
    CrossrefPubMedGoogle Scholar
  • 43 Hrafnkelsson J, Tulinius H, Kjeld M. et al . Serum thyroglobulin as a risk factor for thyroid carcinoma.  Acta Oncol. 2000;  39 973-977
    CrossrefPubMedGoogle Scholar
  • 44 Jeon SJ, Kim E, Park JS. et al . Diagnostic benefit of thyroglobulin measurement in fine-needle aspiration for diagnosing metastatic cervical lymph nodes from papillary thyroid cancer: Correlations with US features.  Korean J Radiol. 2009;  10 106-111
    CrossrefPubMedGoogle Scholar
  • 45 Karges W, Dralle H, Raue F. et al . Calcitonin measurement to detect medullary thyroid carcinoma in nodular goiter: German evidence-based consensus recommendation.  Exp Clin Endocrinol Diabetes. 2004;  112 52-58
    Article in Thieme ConnectPubMedGoogle Scholar
  • 46 Lando A, Holm K, Nysom K. et al . Serum thyroglobulin as a marker of thyroid neoplasms after childhood cancer.  Acta Paediatr. 2003;  92 ((11)) 1284-1290
    CrossrefPubMedGoogle Scholar
  • 47 Lima N, Cavaliere H, Tomimori E. et al . Prognostic value of serial serum thyroglobulin determinations after total thyroidectomy for differentiated thyroid cancer.  J Endocrinol Invest. 2002;  25 110-115
    PubMedGoogle Scholar
  • 48 Lind L, Bucht E, Ljunghall S. Pronounced elevation in circulating calcitonin in critical care patients is related to the severity of illness and survival.  Intensive Care Med. 1995;  21 63-66
    CrossrefPubMedGoogle Scholar
  • 49 Madeddu G, Casu AR, Costanza C. et al . Serum thyroglobulin levels in the diagnosis and follow-up of subacute ‘painful’ thyroiditis. A sequential study.  Arch Intern Med. 1985;  145 243-247
    CrossrefPubMedGoogle Scholar
  • 50 Mariotti S, Barbesino G, Caturegli P. et al . Assay of thyroglobulin in serum with thyroglobulin autoantibodies: An unobtainable goal?.  J Clin Endocrinol Metab. 1995;  80 468-472
    CrossrefPubMedGoogle Scholar
  • 51 Marrinan M, Skrabanek P, Moriarty M. et al . Hypercalcitoninaemia in medullary carcinoma of the thyroid and other malignancies: Value of calcitonin as tumour marker.  Horm Metab Res. 1982;  14 213-215
    Article in Thieme ConnectPubMedGoogle Scholar
  • 52 Martinetti A, Seregni E, Ferrari L. et al . Evaluation of circulating calcitonin: analytical aspects.  Tumori. 2003;  89 566-568
    PubMedGoogle Scholar
  • 53 Mazzaferri EL, Robbins RJ, Spencer CA. et al . A consensus report of the role of serum thyroglobulin as a monitoring method for low-risk patients with papillary thyroid carcinoma.  J Clin Endocrinol Metab. 2003;  88 1433-1441
    CrossrefPubMedGoogle Scholar
  • 54 Menzel C, Grünwald F, Biersack HJ. Monitoring of low-risk patients with papillary thyroid carcinoma.  J Clin Endocrinol Metab. 2003;  88 4507
    CrossrefPubMedGoogle Scholar
  • 55 Morgenthaler NG, Froehlich J, Rendl J. et al . Technical evaluation of a new immunoradiometric and a new immunoluminometric assay for thyroglobulin.  Clin Chem. 2002;  48 1077-1083
    PubMedGoogle Scholar
  • 56 Morita T, Tamai H, Ohshima A. et al . Changes in serum thyroid hormone, thyrotropin and thyroglobulin concentrations during thyroxine therapy in patients with solitary thyroid nodules.  J Clin Endocrinol Metab. 1989;  69 227-230
    CrossrefPubMedGoogle Scholar
  • 57 Moriyama K, Akamizu T, Umemoto M. et al . A case of Hashimoto's thyroiditis with markedly elevated serum thyroglobulin and evidence of its influence on the measurement of anti-thyroglobulin antibody by highly sensitive assays.  Endocr J. 1999;  46 687-693
    CrossrefPubMedGoogle Scholar
  • 58 Morris LF, Waxman AD, Braunstein GD. Interlaboratory comparison of thyroglobulin measurements for patients with recurrent or metastatic differentiated thyroid cancer.  Clin Chem. 2002;  48 1371-1372
    PubMedGoogle Scholar
  • 59 Müller-Gärtner HW, Schneider C, Tempel MT. Serum-Thyreoglobulin in der Metastasendiagnostik des differenzierten Schilddrüsenkarzinoms.  Nuklearmedizin. 1986;  25 194-200
    PubMedGoogle Scholar
  • 60 Müller-Gärtner HW, Schneider C. Clinical evaluation of tumor characteristics predisposing serum thyroglobulin to be undetectable in patients with differentiated thyroid cancer.  Cancer. 1988;  61 976-981
    CrossrefPubMedGoogle Scholar
  • 61 Niccoli P, Brunet P, Roubicek C. et al . Abnormal calcitonin basal levels and pentagastrin response in patients with chronic renal failure on maintenance hemodialysis.  Eur J Endocrinol. 1995;  132 75-81
    CrossrefPubMedGoogle Scholar
  • 62 Oishi S, Shimada T, Tajiri J. et al . Elevated serum calcitonin levels in patients with thyroid disorders.  Acta Endocrinol (Copenh). 1984;  107 476-481
    PubMedGoogle Scholar
  • 63 Pacini F, Fontanelli M, Fugazzola L. et al . Routine measurement of serum calcitonin in nodular thyroid diseases allows the preoperative diagnosis of unsuspected sporadic medullary thyroid carcinoma.  J Clin Endocrinol Metab. 1994;  78 826-829
    CrossrefPubMedGoogle Scholar
  • 64 Pacini F, Lari R, Mazzeo S. et al . Diagnostic value of a single serum thyroglobulin determination on and off thyroid suppressive therapy in the follow-up of patients with differentiated thyroid cancer.  Clin Endocrinol (Oxf). 1985;  23 405-411
    CrossrefPubMedGoogle Scholar
  • 65 Pacini F, Schlumberger M, Dralle H. European Thyroid Cancer Taskforce . European consensus for the management of patients with differentiated thyroid carcinoma of the follicular epithelium.  Eur J Endocrinol. 2006;  154 787-803 , [Erratum (2006) 155:385]
    CrossrefPubMedGoogle Scholar
  • 66 Panza N, Lombardi G, De Rosa M. et al . High serum thyroglobulin levels Diagnostic indicators in patients with metastases from unknown primary sites.  1987;  60 2233-2236
    CrossrefPubMedGoogle Scholar
  • 67 Pellegriti G, Scollo C, Regalbuto C. et al . The diagnostic use of the rhTSH/thyroglobulin test in differentiated thyroid cancer patients with persistent disease and low thyroglobulin levels.  Clin Endocrinol (Oxf). 2003;  58 556-561
    CrossrefPubMedGoogle Scholar
  • 68 Persoon AC, Jager PL, Sluiter WJ. et al . A sensitive Tg assay or rhTSH stimulated Tg: what's the best in the long-term follow-up of patients with differentiated thyroid carcinoma?.  PLoS One. 2007;  2 e816
    CrossrefPubMedGoogle Scholar
  • 69 Pötzi C, Moameni A, Karanikas G. et al . Comparison of iodine uptake in tumour and nontumour tissue under thyroid hormone deprivation and with recombinant human thyrotropin in thyroid cancer patients.  Clin Endocrinol (Oxf). 2006;  65 519-523
    CrossrefPubMedGoogle Scholar
  • 70 Preissner CM, O’Kane DJ, Singh RJ. et al . Phantoms in the assay tube: heterophile antibody interferences in serum thyroglobulin assays.  J Clin Endocrinol Metab. 2003;  88 3069-3074
    CrossrefPubMedGoogle Scholar
  • 71 Rieu M, Lame MC, Richard A. et al . Prevalence of sporadic medullary thyroid carcinoma: the importance of routine measurement of serum calcitonin in the diagnostic evaluation of thyroid nodules.  Clin Endocrinol (Oxf). 1995;  42 453-460
    CrossrefPubMedGoogle Scholar
  • 72 Rink T, Dembowski W, Schroth HJ. et al . Impact of serum thyroglobulin concentration in the diagnosis of benign and malignant thyroid diseases.  Nuklearmedizin. 2000;  39 133-138
    PubMedGoogle Scholar
  • 73 Rink T, Truong PN, Schroth HJ. et al . Calculation and validation of a plasma calcitonin limit for early detection of medullary thyroid carcinoma in nodular thyroid disease.  Thyroid. 2009;  19 327-332
    CrossrefPubMedGoogle Scholar
  • 74 Saller B, Görges R, Reinhardt W. et al . Sensitive calcitonin measurement by two-site immunometric assays: Implications for calcitonin screening in nodular thyroid disease.  Clin Lab. 2002;  48 191-200
    PubMedGoogle Scholar
  • 75 Sapin R, Gasser F, Chambron J. Recovery determination in 600 sera analyzed for thyroglobulin with a recently commercialized IRMA kit.  Clin Chem. 1992;  38 1920-1921
    PubMedGoogle Scholar
  • 76 Schlumberger M, Berg G, Cohen O. et al . Follow-up of low-risk patients with differentiated thyroid carcinoma: A European perspective.  Eur J Endocrinol. 2004;  150 105-112
    CrossrefPubMedGoogle Scholar
  • 77 Schlumberger M, Fragu P, Gardet P. et al . A new immunoradiometric assay (IRMA) system for thyroglobulin measurement; in the follow-up of thyroid cancer patients.  Eur J Nucl Med. 1991;  18 153-157
    CrossrefPubMedGoogle Scholar
  • 78 Schlumberger M, Pacini F. eds Thyroid tumors. Serum thyroglobulin measurement, Chap 7.2.3  Éditions Nucléon, Paris 1999: 136-140
    PubMedGoogle Scholar
  • 79 Schneider AB, Shore-Freedman E, Ryo UY. et al . Prospective serum thyroglobulin measurements in assessing the risk of developing thyroid nodules in patients exposed to childhood neck irradiation.  J Clin Endocrinol Metab. 1985;  61 ((3)) 547-550
    CrossrefPubMedGoogle Scholar
  • 80 Shah DH, Kumar A, Vijayan U. et al . Clinical utility of serum thyroglobulin in metastatic disease.  Indian J Med Res. 1994;  100 232-236
    PubMedGoogle Scholar
  • 81 Sheu SY, Görges R, Schmid KW. Hyperplasien der Schilddrüse.  Pathologe. 2003;  24 348-356
    CrossrefPubMedGoogle Scholar
  • 82 Smallridge RC, Meek SE, Morgan MA. et al . Monitoring thyroglobulin in a sensitive immunoassay has comparable sensitivity to recombinant human tsh-stimulated thyroglobulin in follow-up of thyroid cancer patients.  J Clin Endocrinol Metab. 2007;  92 82-87
    CrossrefPubMedGoogle Scholar
  • 83 Snozek CL, Chambers EP, Reading CC. et al . Serum thyroglobulin, high-resolution ultrasound, and lymph node thyroglobulin in diagnosis of differentiated thyroid carcinoma nodal metastases.  J Clin Endocrinol Metab. 2007;  92 4278-4281
    CrossrefPubMedGoogle Scholar
  • 84 Spencer CA, LoPresti JS, Fatemi S. et al . Detection of residual and recurrent differentiated thyroid carcinoma by serum thyroglobulin measurement.  Thyroid. 1999;  9 435-441
    CrossrefPubMedGoogle Scholar
  • 85 Spencer CA, Takeuchi M, Kazarosyan M. Current status and performance goals for serum thyroglobulin assays.  Clin Chem. 1996;  42 164-173
    PubMedGoogle Scholar
  • 86 Spencer CA, Wang CC. Thyroglobulin measurement.  Techniques, clinical benefits, and pitfalls. Endocrinol Metab Clin North Am. 1995;  24 841-863
    PubMedGoogle Scholar
  • 87 Szanto J, Vincze B, Sinkovics I. et al . Postoperative thyroglobulin level determination to follow up patients with highly differentiated thyroid cancer.  Oncology. 1989;  46 99-104
    CrossrefPubMedGoogle Scholar
  • 88 Thoresen SO, Myking O, Glattre E. et al . Serum thyroglobulin as a preclinical tumor marker in subgroups of thyroid cancer.  Br J Cancer. 1988;  57 105-108
    CrossrefPubMedGoogle Scholar
  • 89 Unger J. Serum thyroglobulin concentration may be a clue to the mechanism of amiodarone-induced thyrotoxicosis.  J Endocrinol Invest. 1988;  11 689
    PubMedGoogle Scholar
  • 90 Uruno T, Miyauchi A, Shimizu K. et al . Usefulness of thyroglobulin measurement in fine-needle aspiration biopsy specimens for diagnosing cervical lymph node metastasis in patients with papillary thyroid cancer.  World J Surg. 2005;  29 483-485
    CrossrefPubMedGoogle Scholar
  • 91 Wang PW, Wang ST, Liu RT. et al . Levothyroxine suppression of thyroglobulin in patients with differentiated thyroid carcinoma.  J Clin Endocrinol Metab. 1999;  84 4549-4553
    CrossrefPubMedGoogle Scholar
  • 92 Weightman DR, Mallick UK, Fenwick JD. et al . Discordant serum thyroglobulin results generated by two classes of assay in patients with thyroid carcinoma: Correlation with clinical outcome after 3 years of follow-up.  Cancer. 2003;  98 41-47
    CrossrefPubMedGoogle Scholar
  • 93 Zöphel K, Wunderlich G, Kotzerke J. A highly sensitive thyroglobulin assay has superior diagnostic sensitivity for recurrence of differentiated thyroid cancer in patients undergoing TSH suppression.  J Nucl Med. 2006;  47 552-553
    PubMedGoogle Scholar
  • 94 Zöphel K, Wunderlich G, Liepach U. et al . Wiederfindungstest oder immunradiometrische Bestimmung der Autoantikörper gegen Thyreoglobulin zur Interpretation der Thyreoglobulinbestimmung in der Nachsorge des differenzierten Schilddrüsenkarzinoms.  Nuklearmedizin. 2001;  40 155-163
    PubMedGoogle Scholar
  • 95 Zöphel K, Wunderlich G, Smith BR. Serum thyroglobulin measurements with a high sensitivity enzyme-linked immunosorbent assay: is there a clinical benefit in patients with differentiated thyroid carcinoma?.  Thyroid. 2003;  13 861-865
    CrossrefPubMedGoogle Scholar

PD Dr. Rainer Görges

Klinik für Nuklearmedizin

Universitätsklinikum Essen

Hufelandstraße 55

45122 Essen

Phone: + 49/201/723-2032

Fax: + 49-201/723-5964

Email: rainer.goerges@uni-due.de

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